Federal and State Laws and Other Policies Limit how These Professionals can Help Meet the Growing Need for Primary Care

Nurse practitioners are a type of advanced practice registered nurse. They are registered nurses who have also obtained a post-graduate nursing degree, typically a master’s. Socalled scope-of-practice laws in many states give these professionals the ability to perform a wide range of primary care services that may be offered when people make an initial approach to a doctor or nurse for treatment, as well as ongoing care for chronic diseases.

With a predicted shortage of primary care as the population grows, and as millions of people become newly insured starting in 2014, one proposed solution is to expand the role of nurse practitioners in many more areas of the country, and to allow them to provide a wider range of preventive and acute health care services.

Some physician groups oppose an expansion of nurse practitioners’ scope of practice, citing concerns over patient safety. Much of the controversy plays out in state capitals, where medical boards and legislators determine scope of practice for nonphysicians, including nurse practitioners. There are also considerations at the federal level that bear on nurse practitioners’ ability to be reimbursed for the care that they provide.

This Health Policy Brief examines the policy proposals for allowing nurse practitioners to practice to their full potential and the accompanying debate, and was published online May 15, 2013 in Health Affairs.

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